Revenue Integrity Clinical & Business Process Engineer

Tria Federal is seeking a Revenue Integrity Clinical & Business Process Engineer to support the Defense Health Agency (DHA) in optimizing enterprise-wide revenue integrity workflows across the Military Health System (MHS). This role applies clinical operations insight, process engineering, and Lean/Six Sigma methodologies to assess, design, and standardize end-to-end revenue cycle workflows that improve charge capture accuracy, billing timeliness, and financial performance.

The ideal candidate brings deep experience across front-, mid-, and back-end revenue cycle processes and can translate operational and clinical complexity into scalable, compliant, and data-driven process improvements.

**This opportunity is contingent upon award.**

Key Responsibilities:

• Lead current-state assessments of clinical and revenue cycle workflows, including scheduling, registration, documentation, coding, charge capture, billing, and denials.
• Facilitate process mapping, value stream analysis, root cause analysis, and stakeholder working sessions across clinical, financial, and operational teams.
• Design and document future-state workflows, standard work, and control plans aligned to DHA revenue integrity objectives.
• Collaborate with Cerner/MHS GENESIS solution owners, coding, billing, analytics, and revenue cycle stakeholders to ensure workflows align with system capabilities and regulatory requirements.
• Identify, define, and operationalize key performance metrics and KPIs, including DNFB, late charges, denial rates, and charge lag.
• Drive continuous process improvement initiatives using Lean, Six Sigma, or similar methodologies, including pilots and phased implementations.
• Partner with data and BI teams to ensure availability of accurate, actionable dashboards for clinical and business stakeholders.
• Develop training, change management, and communication materials to support adoption of redesigned workflows and controls.
• Communicate findings, risks, and recommendations to DHA leadership through clear documentation, briefings, and executive-level reporting.
• Ensure redesigned processes comply with DHA policies, TRICARE requirements, and federal financial management guidance.

Required Skills & Experience:

• Bachelor’s degree in Industrial Engineering, Systems Engineering, Healthcare Administration, Business, or related field; Master’s degree preferred.
• 5+ years of experience in healthcare operations improvement, revenue integrity, revenue cycle consulting, or process engineering.
• Demonstrated experience applying Lean, Six Sigma, or similar methodologies in clinical or revenue cycle environments (Green Belt or higher preferred).
• Strong understanding of end-to-end revenue cycle workflows and key control points impacting charge capture, billing, and reimbursement.
• Experience working with enterprise EHR and billing systems, preferably MHS GENESIS (Oracle/Cerner).
• Familiarity with healthcare analytics and reporting tools (e.g., Excel, Power BI, Tableau, SAS).
• Proven ability to lead cross-functional initiatives involving clinical, financial, IT, and operational stakeholders.
• Advanced analytical and documentation skills, with the ability to translate data findings into actionable, enterprise-level recommendations.
• Proficiency with Microsoft Excel (pivot tables, data analysis) and PowerPoint for executive-level communication.
• Excellent written and verbal communication skills, including experience briefing senior and cross-functional stakeholders.
• Ability to obtain and maintain a Public Trust clearance.